scholarly journals A comparative study of glottis visualization according to the method of lifting the epiglottis in video laryngoscopy: indirect and direct lifting methods

2021 ◽  
Author(s):  
Ji Youn Oh ◽  
Ji Hye Lee ◽  
Yu Yil Kim ◽  
Seung Min Baek ◽  
Da Wa Jung ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Comparative Study ◽  
Prospective Study ◽  
General Anesthesia ◽  
Video Laryngoscope ◽  
Video Laryngoscopy ◽  
Lehane Grade ◽  
Significant Difference ◽  
Blade Tip ◽  
The Difference

Background: The direct entry of the camera under the epiglottis may provide a better view of the glottis than the indirect lifting of the epiglottis by placing the Macintosh blade tip on the vallecula when using the video laryngoscope. This study aimed to compare the efficiency of two different methods of lifting the epiglottis during the visualization of glottis using video laryngoscopy in the same patient.Methods: This prospective study enrolled 60 patients who underwent general anesthesia with tracheal intubation. In each patient, glottic views were obtained by directly (group DE) and indirectly lifting the epiglottis (group IE). These two methods were compared using the modified Cormack and Lehane grade and the percentage of glottis opening (POGO) score as assessment parameters.Results: Modified Cormack and Lehane grade showed significant difference between the groups DE and IE (P = 0.004). The difference in the POGO score between the groups DE and IE was also statistically significant (87.5% and 64.4%, respectively; P < 0.001).Conclusions: Our results, therefore, revealed that the method of directly lifting epiglottis was better at exposing glottis than the method of indirectly lifting epiglottis using a video laryngoscope.

Macintosh laryngoscope, i-view™, and C-MAC® video laryngoscopes for tracheal intubation with an aerosol box: A randomized, crossover, manikin study

2020 ◽  
Author(s):  
Toshiyuki Nakanishi ◽  
Yoshiki Sento ◽  
Yuji Kamimura ◽  
Kazuya Sobue
Keyword(s):  
Intensive Care ◽  
Tracheal Intubation ◽  
Success Rate ◽  
Macintosh Laryngoscope ◽  
Video Laryngoscope ◽  
Interquartile Range ◽  
Intubation Time ◽  
Lehane Grade ◽  
Significant Difference ◽  
Difficulty Scale

Abstract Background: The aerosol box was designed to prevent cough droplets from spreading, but it can impede tracheal intubation. We tested the hypothesis that the C-MAC® video laryngoscope (C-MAC) with an external display is more useful than the i-view™ video laryngoscope (i-view) with an integrated display, or a Macintosh direct laryngoscope (Macintosh) for tracheal intubation with an aerosol box.Methods: This prospective, randomized, crossover simulation study was conducted at an operating room of the two hospitals (a university hospital and a tertiary teaching hospital). We recruited 37 medical personnel (36 anesthesiologists and 1 dental anesthesiologist) who were working in the fields of anesthesia and intensive care with > 2 years of dedicated anesthesia experience from five hospitals. We divided the participants into six groups to use the laryngoscope in a determined order. After the training using each laryngoscope without a box, the participants performed tracheal intubation thrice with each laryngoscope with at least two-hour intervals. The primary outcome was the intubation time. The secondary outcomes were the success rate, Cormack-Lehane grade, and subjective difficulty scale score (numeric rating scale 0–10, 0: no difficulty, 10: highest difficulty). We used the Friedman test and the Wilcoxon signed-rank test with Bonferroni adjustment. Data are shown as median [interquartile range].Results: Thirty-seven personnel (11 women and 26 men) with 12 [5–19] (median [interquartile range]) years of anesthesia and intensive care experience were enrolled. There was no significant difference in the intubation time: 30 [26–32] s for Macintosh, 29 [26–32] s for i-view, and 29 [25–31] s for C-MAC (P=0.247). The success rate was 95%–100% without significant difference (P=0.135). The i-view and C-MAC video laryngoscopes exhibited superior Cormack-Lehane grades and lower subjective difficulty scale scores than the Macintosh laryngoscope; however, there were no differences between the i-view and C-MAC video laryngoscopes.Conclusions: Rapid and highly successful tracheal intubation was possible with Macintosh laryngoscope, i-view, and C-MAC video laryngoscopes on a manikin with an aerosol box. Improved Cormack-Lehane grade and ease of procedure may support the use of video laryngoscopes.Trial registration: UMIN Clinical Trials Registry, identifier UMIN000040269.

scholarly journals Hemodynamic changes during orotracheal intubation using Airtraq video laryngoscope and direct laryngoscope: A randomized comparative study

2019 ◽  
Author(s):  
Sarobar Upadhyaya ◽  
Laxmi Pathak
Keyword(s):  
Heart Rate ◽  
Comparative Study ◽  
Direct Laryngoscopy ◽  
Video Laryngoscope ◽  
Video Laryngoscopy ◽  
Response Alternative ◽  
Intubation Time ◽  
Hemodynamic Changes ◽  
Direct Laryngoscope ◽  
Significant Difference

Introduction: Direct laryngoscopy is associated with sympathetic stimulation and altered hemodynamics. A long intubation time may result in a greater in stress response. Alternative techniques using video laryngoscopes have been developed that do not require direct vocal cord visualization and may decrease the hemodynamic response. This study aimed to compare the difference between hemodynamic changes and intubation time with Airtraq video laryngoscope and conventionl Macintosh direct laryngoscope. Methods: A prospective randomized comparative study was conducted involving 100 adult patients who were undergoing elective surgeries under general anesthesia and endotracheal intubation. The patients were randomly assigned to group V (Video laryngoscope) or group D (Direct laryngoscope). In addition to the baseline vitals and vitals at various time intervals, intubation time was also recorded. We considered a difference in Heart Rate and Mean Arterial pressure of 20% to be clinically significant and statistical significance was p-value <0.05. Results: Significant difference was found in heart rates immediately after laryngoscopy (110.40 vs. 105.02 beats/minute; p<0.01) and 1 minute after intubation (109.30 vs. 106.20 beats/minute; p<0.01) with attenuation seen in video laryngoscopy group. Blood pressures were similar in both the groups at all times. Time for intubation was prolonged in video laryngoscopy group than that for direct laryngoscopy group (26.54 vs. 22.80 seconds; p<0.05). There were no adverse events associated with either of the techniques.  Conclusions: The Airtraq video laryngoscopy resulted in lesser change in heart rate and longer intubation time. However, clinical impact of such a difference seemed to be insignificant.

scholarly journals Macintosh laryngoscope and i-view™ and C-MAC® video laryngoscopes for tracheal intubation with an aerosol box: a randomized crossover manikin study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Toshiyuki Nakanishi ◽  
Yoshiki Sento ◽  
Yuji Kamimura ◽  
Kazuya Sobue
Keyword(s):  
Tracheal Intubation ◽  
Success Rate ◽  
Macintosh Laryngoscope ◽  
Video Laryngoscope ◽  
Intubation Time ◽  
Care Experience ◽  
Manikin Study ◽  
Lehane Grade ◽  
Significant Difference ◽  
Difficulty Scale

Abstract Background We tested the hypothesis that the C-MAC® video laryngoscope (C-MAC) with an external display is more useful than the disposable i-view™ video laryngoscope (i-view) with an integrated display or a Macintosh direct laryngoscope (Macintosh) for tracheal intubation with an aerosol box. Methods In this randomized, crossover manikin study, we recruited 37 medical personnel with > 2 years of dedicated anesthesia experience from five hospitals. After the three successful intubations within 60 s using each laryngoscope without a box, the participants performed tracheal intubation thrice with each laryngoscope with at least 2-h intervals in a determined order. The primary outcome was the intubation time. The secondary outcomes were success rate, Cormack-Lehane grade, and subjective difficulty scale score. Results Thirty-seven personnel (11 women and 26 men) with 12 [5–19] (median [interquartile range]) years of anesthesia and intensive care experience were enrolled. There was no significant difference in the intubation time: 30 [26–32] s for Macintosh, 29 [26–32] s for i-view, and 29 [25–31] s for C-MAC (P = 0.247). The success rate was 95–100%, without a significant difference (P = 0.135). The i-view and C-MAC exhibited superior Cormack-Lehane grades and lower subjective difficulty scale scores than the Macintosh; however, there were no differences between the i-view and C-MAC. Conclusions Rapid and highly successful tracheal intubation was possible with both Macintosh, i-view, and C-MAC on a normal airway manikin in an aerosol box. Improved Cormack-Lehane grade and the ease of performing the procedure may support the use of video laryngoscopes. Trial registration UMIN Clinical Trials Registry, UMIN000040269. Registered 30 April 2020.

scholarly journals Analysis of tracheal intubation in out-of-hospital helicopter emergency medicine recorded by video laryngoscopy

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Jürgen Knapp ◽  
Bettina Eberle ◽  
Michael Bernhard ◽  
Lorenz Theiler ◽  
Urs Pietsch ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Quality Control ◽  
Tracheal Intubation ◽  
Airway Management ◽  
Success Rate ◽  
Video Laryngoscope ◽  
Solar Irradiation ◽  
Video Laryngoscopy ◽  
Trauma Patients ◽  
Intubation Success

Abstract Background Tracheal intubation remains the gold standard of airway management in emergency medicine and maximizing safety, intubation success, and especially first-pass intubation success (FPS) in these situations is imperative. Methods We conducted a prospective observational study on all 12 helicopter emergency medical service (HEMS) bases of the Swiss Air Rescue, between February 15, 2018, and February 14, 2019. All 428 patients on whom out-of-hospital advanced airway management was performed by the HEMS crew were included. The C-MAC video laryngoscope was used as the primary device for tracheal intubation. Intubation procedures were recorded by the video laryngoscope and precise time points were recorded to verify the time necessary for each attempt and the overall procedure time until successful intubation. The videos were further analysed for problems and complications during airway management by an independent reviewer. Additionally, a questionnaire about the intubation procedure, basic characteristics of the patient, circumstances, environmental factors, and the provider’s level of experience in airway management was filled out. Main outcome measures were FPS of tracheal intubation, overall success rate, overall intubation time, problems and complications of video laryngoscopy. Results FPS rate was 87.6% and overall success rate 98.6%. Success rates, overall time to intubation, and subjective difficulty were not associated to the providers’ expertise in airway management. In patients undergoing CPR FPS was 84.8%, in trauma patients 86.4% and in non-trauma patients 93.3%. FPS in patients with difficult airway characteristics, facial trauma/burns or obesity ranges between 87 and 89%. Performing airway management indoors or inside an ambulance resulted in a significantly higher FPS of 91.1% compared to outdoor locations (p < 0.001). Direct solar irradiation on the screen, fogging of the lens, and blood on the camera significantly impaired FPS. Several issues for further improvements in the use of video laryngoscopy in the out-of-hospital setting and for quality control in airway management were identified. Conclusion Airway management using the C-MAC video laryngoscope with Macintosh blade in a group of operators with mixed experience showed high FPS and overall rates of intubation success. Video recording emergency intubations may improve education and quality control.

scholarly journals A comparative study of functional outcome between platelet rich plasma injection versus steroid infiltration in plantar fasciitis

2020 ◽  
Vol 6 (2) ◽  
pp. 393
Author(s):  
Harpreet Singh ◽  
Malay P. Gandhi ◽  
Aliasgar J. Rampurwala ◽  
Tej S. Rudani
Keyword(s):  
Comparative Study ◽  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Injection Group ◽  
Plasma Injection ◽  
Significant Difference ◽  
The Difference ◽  
The Individual

<p class="abstract"><strong>Background:</strong> Plantar fasciitis (PF) is considered as degenerative tendinopathies. Repeated micro trauma is the major etiology of these diseases. Autologous platelet rich plasma (PRP) injections are becoming more popular in the treatment of enthesopathies like PF. The growth factors in PRP cause tissue healing. We compared the result of injecting intra-lesional autologous PRP injections versus steroid infiltration in chronic PF.</p><p class="abstract"><strong>Methods:</strong> A prospective, interventional and analytic comparative study was done and 81 patients (120 heels) were included in this study and were followed up for 6 months. We assessed the outcome of each patient using visual analog score (VAS) and foot and ankle disability index (FADI) on follow-up at 1, 3, and 6 months. <strong></strong></p><p class="abstract"><strong>Results:</strong> In our study, female preponderance was seen. Left side was more common as compared to right side. Unilateral PF is more common than bilateral. The difference with in the individual group at baseline and at 1,3 and 6 months was statistically highly significant in terms of VAS and FADI (p=0.0001) But the difference in the between the two groups was insignificant for VAS and FADI at 1, 3 and 6 months.</p><p class="abstract"><strong>Conclusions:</strong> In our study, as there is no significant difference in VAS and FADI score between corticosteroid injection group and PRP injection group at 1, 3 and 6 months follow up. So, it’s reasonable to conclude that both are equally effective in PF. But as PRP injection comes out to be more time consuming and more costly, corticosteroid seems to be more efficient, cost and time wise. Hence, the latter should be a better choice.      </p>

scholarly journals The midline approach for endotracheal intubation using GlideScope video laryngoscopy could provide better glottis exposure in adults： A randomized controlled trial

2019 ◽  
Author(s):  
Lianxiang Jiang ◽  
Shulin Qiu ◽  
Peng Zhang ◽  
Weidong Yao ◽  
Yan Chang ◽  
...  
Keyword(s):  
Tracheal Intubation ◽  
Endotracheal Intubation ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Video Laryngoscopy ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Midline Approach ◽  
Approach Group

Abstract Background: Previous studies have demonstrated that the common laryngoscopic approach (right-sided) and midline approach are both used for endotracheal intubation by direct laryngoscopy. Although the midline approach is commonly recommended for video laryngoscopy (VL) in the clinic, there is a lack of published evidences to support this practice. This study aimed to evaluate the effects of different video laryngoscopic approaches on intubation. Methods: Two hundred sixty-two patients aged 18 years who underwent elective surgery under general anaesthesia and required endotracheal intubation were included in the present prospective, randomized, controlled study. The participants were randomly and equally allocated to the right approach (Group R) or midline approach (Group M). All the intubations were conducted by experienced anaesthetists using GlideScope video laryngoscopy. The primary outcomes were Cormack-Lehane laryngoscopic views (CLVs) and first-pass success (FPS) rates. The secondary outcomes were the time to glottis exposure, time to tracheal intubation, haemodynamic responses and other adverse events. Comparative analysis was performed between the groups. Results: Finally, 262 patients completed the study, and all the tracheas were successfully intubated. No significant differences were observed in the patient characteristics and airway assessments ( P >0.05). Compared with Group R, Group M had a better CLV ( χ2 =14.706, P =0.001) and shorter times to glottis exposure (8.82±2.04 vs 12.38±1.81; t =14.94; P <0.001) and tracheal intubation (37.19±5.01 vs 45.23±4.81; t =13.25; P <0.001), but no difference was found in the FPS rate (70.2% vs 71.8%; χ2 =0.074; P =0.446) and intubation procedure time (29.86±2.56 vs 30.46±2.97, t =1.75, P =0.081). Between the groups, the rates of hoarseness or sore throat, minor injury, hypoxemia and changes in SBP and HR showed no significant difference ( P >0.05). Conclusion: Although the FPS rate did not differ based on the laryngoscopic approach, the midline approach could provide better glottis exposure and shorter times to glottis exposure and intubation. The midline approach should be recommended for teaching in VL-assisted endotracheal intubation. Trial registration: The study was registered in the Chinese Clinical Trial Registry ( ChiCTR-RNC-1900023252 ).

scholarly journals Effectivity battle between C-MAC and McGrath® video laryngoscope in a patient with general anesthesia at Sanglah Hospital: A pilot study

2021 ◽  
Vol 4 (2) ◽  
pp. 47-50
Author(s):  
Jhoni Pardomuan Pasaribu ◽  
Tjokorda Gde Agung Senapathi ◽  
Pontisomaya Parami
Keyword(s):  
Pilot Study ◽  
Tracheal Intubation ◽  
General Anesthesia ◽  
Video Laryngoscope ◽  
Hemodynamic Change ◽  
Successful Intubation ◽  
Success Rates ◽  
Physical Status ◽  
Hemodynamic Stability ◽  
Pros And Cons

Background: Intubation is a common essential procedure to maintain the airway during general anesthesia. Various video laryngoscopes (VL) on the market today assist anesthesiologists in improving intubation success rates and also in complicated airway cases. There are two types of VL found in our institution, which are C-MAC and McGrath®. Each of them has its pros and cons, which withdrawn our curiosity to compare their effectiveness.  Methods: A pilot study was conducted in our center; we included all patients undergoing general anesthesia with physical status ASA I-III and consent to the study and divide them into two groups, C-MAC and McGrath®. We compare C-MAC and McGrath® VL effectiveness in terms of time for intubation, ease of intubation, total attempt, failure to intubate, Cormack Lehane degree, POGO Score, and hemodynamic stability.  Results: A total of 20 patients were intubated with two different VL, ten patients for each group. Both VLs accommodate ease of intubation, and overall first attempt successful intubation, though C-MAC showed better laryngeal and glottic visualization, shorter tracheal intubation times, and less hemodynamic change. Conclusion: C-MAC gives better results in laryngeal and glottic visualization, shorter tracheal intubation times, and less hemodynamic change.

scholarly journals Why USB-endoscope laryngoscopy is as effective as video laryngoscopy

2020 ◽  
Vol 43 (2) ◽  
pp. E55-59
Author(s):  
Meliha Findik ◽  
Afsin E. Kayipmaz ◽  
Cemil Kavalci ◽  
Tugce Sencelikel Sencelikel ◽  
Murat Muratoglu ◽  
...  
Keyword(s):  
Direct Laryngoscopy ◽  
Low Cost ◽  
Video Laryngoscope ◽  
Video Laryngoscopy ◽  
Intubation Time ◽  
Direct Laryngoscope ◽  
Correct Placement ◽  
Custom Made ◽  
Significant Difference ◽  
The Cost

Purpose: To compare the efficacy of a low-cost custom-made universal serial bus (USB) endoscope laryngoscope for intubation with a direct laryngoscope and a high-cost video laryngoscope in a mannequin study. Methods: We used one intubation simulator model (mannequin) in our study. A USB endoscope was mounted to the direct laryngoscope as a custom-made USB endoscope laryngoscope (USB-L). We used a video laryngoscope (Glidescope®, Verathon, USA) and a direct laryngoscope (Macintosh) for comparison. Intubation time and the correct placement of the tube were measured. Intubations were performed by two operators and results were compared. Results: We found a statistically significant difference between the video and direct laryngoscope groups (p < 0.001), as well as between the USB-L and direct laryngoscope groups (p = 0.001) for Operator 1. For Operator 2, there was a statistically significant difference between the video laryngoscope group and the direct laryngoscope group (p = 0.022); however, we did not find a significant difference between the USB-L group and the direct laryngoscope group (p = 0.154). Furthermore, there were no significant differences between the USB-L and video laryngoscope groups for either operator (p=0.347 for Operator 1 and p>0.999 for Operator 2). Conclusion: Our study showed that USB endoscope laryngoscope provided similar intubation time to video laryngoscopy at a fraction of the cost; and both had superior times in comparison with direct laryngoscopy.

scholarly journals AGGRESSIVENESS, PESANTREN AND SHIYAM (A COMPARATIVE STUDY)

Proyeksi ◽  
2012 ◽  
Vol 7 (1) ◽  
pp. 109
Author(s):  
Fitriyah Fitriyah ◽  
Falasifatul Falah
Keyword(s):  
Young People ◽  
Comparative Study ◽  
Random Sampling ◽  
Living Environment ◽  
T Test ◽  
Male Adolescents ◽  
Significant Difference ◽  
The Difference ◽  
One Way Anova ◽  
Religious Fasting

Aggressive behaviors by adolescents in Indonesia has perceived as national problem. This problem ofbehavior occur among all background of teenagers, including young people who had religiousbackground. There are two purposes of the study: 1). To examine the difference of aggressivenessbetween adolescent living in pesantren and adolescent living outside pesantren; and 2). To examine thedifference of aggressiveness among adolescents doing different frequency of religious fasting (shiyam),especially non-obligatory (sunnah) fasting on Monday or Thursday. The population of study was 11 to 21years old male-Moslem adolescent living in Kelurahan Bangunharjo, Semarang. Samples of study takenwith random sampling, based on data of residences in Kelurahan Bagunharjo Semarang. Twohypotheses were proposed in this study: 1). There are different aggressiveness between adolescentsliving in pesantren and ones living outside of pesantren; and 2). There are different aggressivenessamong adolescents doing different frequencies of Monday-Thursday shiyam. The first examinationemploying independent sample t-test resulted in t=-4,902 which p=0,00 (p<0,01), showed that the firsthypothesis was proved: there was a very significant difference of aggressiveness between the group ofMuslim-male adolescents living in pesantren and the group of others, the first group showed loweraggressiveness. The second examination employing one-way anova resulted in F=16,736 which p=0, 00(p<0, 01), showed that the second hypothesis was also proved: there was a very significant difference ofaggressiveness among the groups of Muslim-male adolescents with different frequency of religiousfasting (shiyam): the more frequency of religious fasting, the lower aggressiveness was. The result ofstudy suggested that both religious living environment and religious fasting might give contribution todecrease aggressiveness on adolescents.

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